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Meta-Analysis
. 2024 Nov;120(5):1245-1258.
doi: 10.1016/j.ajcnut.2024.09.019. Epub 2024 Sep 21.

The effects of chicory inulin-type fructans supplementation on weight management outcomes: systematic review, meta-analysis, and meta-regression of randomized controlled trials

Raylene A Reimer  1 , Stephan Theis  2 , Yoghatama Cindya Zanzer  2
Affiliations
Meta-Analysis

The effects of chicory inulin-type fructans supplementation on weight management outcomes: systematic review, meta-analysis, and meta-regression of randomized controlled trials

Raylene A Reimer et al. Am J Clin Nutr. 2024 Nov.

Erratum in

Abstract

Background: Excess body weight and adiposity can adversely affect metabolic health. Prebiotics such as inulin-type fructans (ITFs) from chicory root are known to modulate gut microbiota and may improve body weight regulation.

Objectives: This study aimed to assess evidence for chicory ITF supplementation to support weight management.

Methods: Eligible articles (initial search to 2021, updated to February 2023) were searched from EMBASE, MEDLINE (PubMed), and Cochrane Library. Data on primary (body weight) and secondary outcomes [body mass index (BMI), total fat mass, body fat percentage, and waist circumference] were extracted by 2 reviewers independently. Random-effects model using inverse-variance method was used. Subgroup analysis (health status and ITF type) and meta-regression (dose and duration) were evaluated.

Results: A total of 32 eligible studies were included. Chicory ITF significantly reduced body weight [mean difference (MD): -0.97 kg; 95% CI: -1.34, -0.59); n = 1184] compared with placebo. ITF favored overall effects reduction in BMI (MD: -0.39 kg/m2; 95% CI: -0.57, -0.20; n = 985), fat mass (MD: -0.37 kg; 95% CI: -0.61, -0.13; n = 397), waist circumference (MD: -1.03 cm; 95% CI: -1.69, -0.37; n = 604), and for intervention duration of >8 wk, body fat percentage (MD: -0.78%; 95% CI: -1.17, -0.39; n = 488). Except for considerable heterogeneity in body weight (I2: 73%) and body fat percentage (I2: 75%), all other outcomes had negligible to moderate heterogeneity. Significant reduction in body weight, BMI, and waist circumference was evident irrespective of participants' health status. There was minimal evidence that dose, duration, or type of ITF influenced the magnitude of reductions in outcomes.

Conclusions: Chicory ITF supplementation may benefit weight management by reducing body weight, BMI, fat mass, waist circumference, and, to a certain extent, body fat percentage. This systematic review with meta-analysis was registered at PROSPERO as CRD42020184908.

Keywords: inulin; meta-analysis; meta-regression; oligofructose; systematic review; weight management.

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Conflict of interest statement

Conflict of interest YCZ and ST are employed by BENEO Institute, c/o BENEO GmbH, Obrigheim/Pfalz, Germany. BENEO is a company involved in production of food ingredients including prebiotic fructans and polyols. RAR has received consulting fees and speaker honoraria related to presentations on prebiotics.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram. ITF, inulin-type fructan.
FIGURE 2
FIGURE 2
Forest plot of effects of inulin-type fructan (ITF) supplementation on body weight (kg). Values were calculated as baseline-corrected mean difference (MD) and its corresponding 95% CI using random-effects model/inverse-variance method. To account for within-study and between-study variances, the Sidik–Jonkman estimator and Hartung–Knapp adjustment were applied into the model. Interstudy heterogeneity was quantified as I2. Significance level was set at P < 0.05.
FIGURE 3
FIGURE 3
Forest plot of effects of inulin-type fructan (ITF) supplementation on BMI (kg/m2). Values were calculated as baseline-corrected mean difference (MD) and its corresponding 95% CI using random-effects model/inverse-variance method. To account for within-study and between-study variances, the Sidik–Jonkman estimator and Hartung–Knapp adjustment were applied into the model. Interstudy heterogeneity was quantified as I2. Significance level was set at P < 0.05.
FIGURE 4
FIGURE 4
Forest plot of effects of inulin-type fructan (ITF) supplementation on total fat mass (kg). Values were calculated as baseline-corrected mean difference (MD) and its corresponding 95% CI using random-effects model/inverse-variance method. To account for within-study and between-study variances, the Sidik–Jonkman estimator and Hartung–Knapp adjustment were applied into the model. Interstudy heterogeneity was quantified as I2. Significance level was set at P < 0.05.
FIGURE 5
FIGURE 5
Forest plot of effects of inulin-type fructan (ITF) supplementation on body fat percentage (%). Values were calculated as baseline-corrected mean difference (MD) and its corresponding 95% CI using random-effects model/inverse-variance method. To account for within-study and between-study variances, the Sidik–Jonkman estimator and Hartung–Knapp adjustment were applied into the model. Interstudy heterogeneity was quantified as I2. Significance level was set at P < 0.05.
FIGURE 6
FIGURE 6
Forest plot of effects of inulin-type fructan (ITF) supplementation on waist circumference (cm). Values were calculated as baseline-corrected mean difference (MD) and its corresponding 95% CI using random-effects model/inverse-variance method. To account for within-study and between-study variances, the Sidik–Jonkman estimator and Hartung–Knapp adjustment were applied into the model. Interstudy heterogeneity was quantified as I2. Significance level was set at P < 0.05.
FIGURE 7
FIGURE 7
Distribution of risk of bias assessment across 5 domains and overall judgments in included studies.
FIGURE 8
FIGURE 8
Summary assessment on risk of bias based on domain-level judgments.
See this image and copyright information in PMC

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